Update on pre-ECMO evaluation and treatment for term infants in respiratory failure

Kathryn L Fletcher; Rachel Chapman

doi:10.1016/j.siny.2022.101401

Update on pre-ECMO evaluation and treatment for term infants in respiratory failure

Semin Fetal Neonatal Med. 2022 Dec;27(6):101401. doi: 10.1016/j.siny.2022.101401. Epub 2022 Nov 17.

Authors

Kathryn L Fletcher¹, Rachel Chapman²

Affiliations

¹ Division of Perinatal Medicine, Department of Pediatrics, Yale University School of Medicine, New Haven, CT, 333 Cedar Street, LMP, 4085, USA. Electronic address: kathryn.fletcher@yale.edu.
² Department of Pediatrics, USC Keck School of Medicine, Fetal & Neonatal Institute, Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA, 90027, USA. Electronic address: rachapman@chla.usc.edu.

PMID: 36450631
DOI: 10.1016/j.siny.2022.101401

Abstract

The epidemiology, diagnostic and management approach to severe hypoxemic respiratory failure in the term and near-term neonate has evolved over time, as has the need for extracorporeal membrane oxygenation (ECMO) support in this patient population. Many patients who historically would have required ECMO support now respond to less invasive therapies, with patients requiring ECMO generally representing a higher risk and more heterogenous group of underlying diagnoses. This review will highlight these changes over time and the current available evidence for the diagnosis and management of these infants, as well as the current indications and relative contraindications to ECMO support when oxygen delivery cannot meet demand with less invasive management.

Keywords: Extracorporeal membrane oxygenation; Hypertension; Hypoxemic respiratory failure; Neonatology; Pulmonary.

Publication types

Review

MeSH terms

Extracorporeal Membrane Oxygenation*
Humans
Infant, Newborn
Respiratory Insufficiency* / therapy